Active NPI
Connie H Evans
- Dental Hygienist
- San Antonio, TX
National Provider Identifier
1689824971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 14587
- Practice address
- 3750 Commercial Ave
San Antonio, TX 78221-3117 - Phone
- (210) 334-3700
- Fax
- (210) 923-4167
- NPI assigned
- Sep 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 14587 | TX | Primary |
Addresses
Primary practice location
3750 Commercial Ave
San Antonio, TX 78221-3117
Mailing address
3750 Commercial Ave
San Antonio, TX 78221-3117
Phone (210) 334-3700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14587 | Other | TX | TX STATE BOARD OF DENTAL EXAMINERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14587 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266969600000",
"number": "1689824971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3750 COMMERCIAL AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782213117",
"telephone_number": "210-334-3700",
"fax_number": "210-922-0162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 COMMERCIAL AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782213117",
"telephone_number": "210-334-3700",
"fax_number": "210-923-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EVANS",
"first_name": "CONNIE",
"middle_name": "H",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-24",
"last_updated": "2010-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "TX",
"license": "14587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX STATE BOARD OF DENTAL EXAMINERS",
"identifier": "14587",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.